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PRINTED: 01/27/2015 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:FRANCISCAN ST ANTHONY HEALTH CROWN
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What is this visit was for?
This visit was for a routine inspection.
Who is required to file this visit was for?
The responsible party or department is required to file this visit.
How to fill out this visit was for?
This visit should be filled out with accurate and detailed information about the inspection findings.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with regulations and standards.
What information must be reported on this visit was for?
Information such as date of inspection, areas inspected, findings, corrective actions taken, and follow-up plans must be reported on this visit.
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